Menopause and Insomnia: How to Get Better Sleep During Menopause

Menopause and insomnia are often two peas in a pod. As hormone levels change, women can experience symptoms of insomnia. But there are things you can do to sleep better.

By Nicole Gleichmann

Getting enough sleep can be challenging for anyone, but it’s especially difficult for women as we grow older. As our bodies transition from our child-bearing years, we experience a multitude of changes that can make quality sleep seem like a distant memory.

Sleep is critical for our health and quality of life, so it’s important that we do what we can to clock in 7 or more hours every night. When we don’t get enough, we can experience brain fog, fatigue, and memory troubles. Over time, a lack of sleep can result in health conditions like cardiac disease and depression.

This begs the question: why is it so hard for menopausal women to get enough sleep, and what can you do to regain control? By the end of this article, you will have the knowledge you need to get restful, restorative sleep.

What is Menopause?

Menopause is a natural part of women’s lives that occurs once they haven’t had a menstrual cycle for one full year. The period after this 12-months is known as post menopause and the period before is perimenopause.

Perimenopause can start in a women’s late 30s or into her 40s and lasts from two years all the way up to 10 years. During this time, the ovaries production of hormones like estrogen and progesterone slowly decline. It’s this change in hormone levels that leads to tell-tale menopausal symptoms, including hot flashes, mood swings, and sleep problems.

For most women, the most severe symptoms of perimenopause occur in the one to two years prior to menopause due to an accelerated drop in estrogen production. Following menopause, symptoms tend to decline, although lower levels of estrogen can increase the risk of health conditions like cardiovascular disease and osteoporosis.

Insomnia and Menopause

Many women will start having sudden difficulties with sleep in their 30s or 40s that are unknowingly due to perimenopause. Some clues that you might be experiencing menopause-induced sleep disturbances include:

  • Disrupted sleep/trouble staying asleep (particularly if you wake up from feeling too hot)
  • Difficulties falling asleep
  • Waking up early, unable to go back to bed
  • Reduced total amount of time asleep
  • Sleep apnea
  • Daytime fatigue

While it can be difficult to regain quality sleep during menopause, it’s not impossible. Understanding what causes these symptoms and how you can combat them can help you improve your sleep quality and get a good night’s rest.

Why Many Women Experience Trouble Sleeping During Menopause

There are multiple factors that can make sleep difficult for women during this period of their lives. Here we will review some of the most common causes.

1. Sleep Hormone Changes

Estrogen is not only women’s primary sex hormone; it also plays a role in things like mood, weight, and sleep. When it comes to sleep, estrogen is involved in both falling asleep and staying asleep throughout the light. When estrogen levels fall during perimenopause, some women will experience insomnia symptoms.

2. Adrenaline Levels and Hot Flashes

Hot flashes are one of the tell-tale signs of menopause. They’re caused by a rapid spike in adrenaline levels, a hormone that impacts the body in ways that can increase your alertness and body temperature. When adrenaline causes your blood pressure and heart rate to increase when you’re asleep, you will usually quickly wake up with a need to cool down.

3. Lifestyle Changes

Not every reason for sleep trouble at this stage in life is directly related to physiological changes in the body. Around the same time that women will begin to experience menopause symptoms, there are many coincidental lifestyle changes that might occur which can themselves lead to worry, stress, and insomnia. These include:

  • Children moving out of the house
  • The extra financial burden of college tuition
  • Career changes/retirement planning
  • Divorce (kids leaving the home and other events make this phase of life common for divorce)

Because this stage of life is often one filled with lots of changes, the mental impact of outside events can themselves lead to insomnia.

4. Depression and Anxiety

Depression and anxiety can also be symptoms of menopause. In fact, women are two to four times more likely to develop serious depression during menopause than before. These impairments to mental health are brought on by hormonal changes in the body. (It’s also worth noting that women who have a history of depression are 4.5 times more likely to experience additional episodes of depression during menopause when compared with other women.)

Depression and anxiety affect different people in different ways. Sometimes, they can actually cause a person to sleep more, especially during the day. But in other cases, heightened emotions can keep a person awake through the night.

5. Sleep Apnea

Another concern for menopausal women is sleep apnea. Sleep apnea is a sleeping disorder where the breathing suddenly starts and stops; sometimes, it can be quite serious, though it often goes undiagnosed. Sleep apnea often results in snoring, and it can be highly disruptive to healthy sleep patterns.

Sleep apnea may be caused by the loss of reproductive hormones. Indeed, postmenopausal women are two to three times more likely to have sleep apnea, compared with women who have not yet gone through menopause. In fact, many women experience fatigue during the daytime, which they attribute to menopause; often, it’s more accurate to say that it’s caused by sleep apnea.

6. Hot Flashes and Sleep

Approximately 75 percent to 85 percent of menopausal women experience hot flashes, and those hot flashes last for an average of five years. Hot flashes are by far the most common symptom of menopause.

So what is a hot flash, exactly? It’s essentially just the sudden sensation of heat; it can sometimes be accompanied by a flushed or red face, and/or by sweating. Many clinicians believe that hot flashes are connected to changes in circulation, brought on by the dropoff in progesterone production. Basically, blood vessels widen and cool off, which releases heat and causes the woman to break out in a sweat. This sweating can happen day or night, and naturally, it can be a deterrent to restful sleep.

What You Should Do if You’re Struggling with Menopause and Insomnia

If you’re struggling with insomnia and menopause, there are a few lifestyle changes that you can make to improve your sleep.

  • Work on Sleep Hygiene: Setting healthy sleep habits is even more important during this stage of life as it will help keep your sleep cycle normal. This includes going to bed and waking up at roughly the same time every day, limiting light exposure before sleep, and reducing late night distractions (think pets in bed or your phone on your nightstand).
  • Medication: Another option is to talk with your doctor about medication. An antidepressant may help you regulate your mood. Birth control pills can sometimes get hot flashes under control. Consult with your physician about the medicinal options available to you.
  • Stay Cool: Finally, make sure you do everything you can to combat hot flashes and night sweats. Keep the temperature in your room as cool as you can. Wear breathable cotton pajamas. And, invest in a cooling mattress, which will help mediate body heat and promote air circulation.
  • Exercise: Studies have shown conclusively that getting aerobic exercise throughout the week can improve the quality of one’s sleep. Make sure you get up and get moving at least four days out of the week, whether that’s going for a brisk walk, taking a bike ride, or signing up for a pilates class. Just be careful not to work out in the three hours before bedtime, which can actually make it harder to fall asleep.
  •  Use Relaxation Techniques: Women going through menopause may also wish to try some basic relaxation techniques to quiet their minds, push anxiety out of their minds, and prepare their bodies for rest. Yoga, guided meditation apps, and basic breathing exercises can all be helpful here.

Lastly, if you find that your symptoms aren’t going away, see your doctor. They can help you decide if there are treatments that you need (like hormone replacement therapy, or HRT) or natural supplements that might help you sleep better.


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